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Telephonic Case Management RN job in El Dorado Hills, CA


Job summary

Telephonic Case Management RN
Location: El Dorado Hills, CA Category: Medical & Science
Status: Temporary/Contract Reference: US_EN_2_026139_257122
Posted: September 06,2014 Salary: N/A

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Job description

Exciting job opportunity for a full time Telephonic Case Management RN! Candidates can be in OH, FL or CA! Must be bilingual in Spanish and English!

Job Duties:

Examine clinical programs information to identify members for specific clinical interventions by utilizing established screening criteria
Perform telephonic CMRs with members
Deliver all required information, intervention, and member communication in timely manner; track and log appropriately

Assist in developing statewide and national clinical programs, and supporting utilization management
Analyze drug usage reports to identify problems and recommend solutions
Provide clinical drug information and recommendations to appropriate committees
Develop strategies to decrease pharmacy costs for members and the company
Promote company’s clinical programs and resources
Facilitate member clinical program engagement
Support quality improvement programs

Hours are 6a-2:30p, Monday-Friday. Starting pay is $30/hr.

Job Requirements:

Bachelor’s degree strongly preferred
Active RN license in good standing and without restrictions in the State ofCalifornia,FloridaorOhio
Must be bilingual in English & Spanish
Minimum 2 to 5 years’ experience in a clinical setting
A knowledgeable individual with appropriate industry experience, preferably in the healthcare, insurance or PBM industry
Previous experience in case management or disease management, as well as utilization management
Telephonic case management experience preferred
Demonstrated understanding of clinical programs
Medicare Part D knowledge strongly preferred
Strong data analysis and presentation skills
Pharmacy claim analysis experience preferred
Project management experience preferred
Ability to exercise considerable judgment, maintain confidentiality, and act in a diplomatic manner
Ability to independently identify, research and resolve issues
Effective verbal and written communication skills
A decisive individual who possesses a detail oriented perspective
Sound technical skills, analytical ability, good judgment, and strong operational focus
Demonstrated ability to manage multiple priorities and deadlines
A well-organized and self-directed individual who is able to work with minimal amount of supervision
Capability to efficiently complete tasks in a fast paced environment
Ability to work extended hours, weekends, and holidays pursuant with industry demands
Proficient in Microsoft Office and industry related software programs

If you are interested in this Telephonic Case Management RN job please apply online or send your resume directly to for immediate consideration!

Adecco Medical & Science is a specialized medical division of the Swiss owned company Adecco SA, the 4th largest employer in the world. Our strengths in nursing, paramedical, pharmacy, technical support staff and quality assurance, give us a global platform from which to serve our many Clients.

Equal Opportunity Employer Minorities/Women/Veterans/Disabled

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